CentraState - Healthy Directions

www.centrastate.com Fall 2014 11 • Have smoked for 30 "pack years" or more. (A pack year is a pack a day for 30 years or two packs a day for 15 years.) • Still smoke or have quit during the past 15 years. • Are not symptomatic or currently have lung nodules. "Our hope is we're going to find lung cancers in their earliest stage, when they can be surgically removed and the patient is potentially cured," says Sharon Lorfing, RN, MSN, APN-C,a nurse practitioner and cancer navigator at CentraState. "Dorothy was our first patient we found with a stage 1 cancer. She had no symptoms, as most patients don't in this early stage." ADVANCED LUNG SURGERY Dorothy's screening found a small lung nodule, so as guidelines suggest, she had a second CT scan three months later that showed the nodule had grown. Her results, like all lung screening CT scans, were discussed by CentraState's Lung Care team at a bimonthly lung conference. The team includes thoracic surgeons, pulmonologists, radiologists, pathologists, oncologists, and the thoracic nurse practitioner/ navigator. CentraState's lung screening program is considered a center of screening excellence by the Lung Cancer Alliance. "I'll never forget the conversation with Dr. Silberberg," Dorothy says. "He said, 'Your lung nodule is growing,' and we both immediately agreed, 'Let's get it out.'" Dorothy next met with Jean-Phillipe Bocage, MD, a board- certified thoracic surgeon on staff at CentraState. They decided to pursue a lobectomy—the removal of the section of the lung containing the tumor—using a procedure known as video-assisted thoracic surgery, or VATS. VATS is a minimally invasive procedure that uses four, 1-inch incisions to perform complex surgeries inside the chest. The approach greatly reduces post-surgery recovery time, pain and bleeding compared with traditional approaches that involve 8- to 12-inch chest incisions, Dr. Bocage says. Most patients leave the hospital within 24 to 48 hours. "It's beneficial to the patient because we [Dr. Bocage and his partner, Robert Caccavale, MD] are not cutting through the muscles of the chest wall or causing injury to the ribs," he says. "We've been doing this technique together for more than 20 years and have become one of the busier VATS centers in New Jersey, performing over 6,000 VATS in that time." A SPEEDY RECOVERY The April 2014 surgery not only removed Dorothy's tumor, but also found that her lung cancer was at an early stage. As a result, she would not need radiation or chemotherapy treatments. Within a month, Dorothy was back to working out on the stationary bikes and treadmills at CentraState Fitness & Wellness Center. She and her husband, Jim, were also back to planning vacations, including a late winter trip to Australia and New Zealand. Dorothy will continue with follow-up screenings for the next few years to make sure she remains cancer free. "I'm planning for my future," she says. "I can't say enough about the team at CentraState and how well they worked together." A FREE PROGRAM Dr. Silberberg describes Dorothy as the "ideal case" to illustrate the benefit of lung cancer screening. Early detection greatly increases a patient's chances of surviving lung cancer. "We were able to detect a very small, very early lung cancer that may have been much more difficult to treat in the future," he says. "Now, the odds are very good she'll never have any additional problems related to this cancer." In December 2013, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation in favor of annual screening for lung cancer in older adults with a strong history of smoking. However, Medicare and most insurance companies still do not cover the screenings, which is why CentraState has been offering its program at no cost to qualified patients, Lorfing says. A smoking cessation program is also introduced to current smokers as part of the screening curriculum. For more information about CentraState's Comprehensive Lung Program and to determine your eligibility, please contact Sharon Lorfing, nurse practitioner and program coordinator, at 732-637-6365. HD Dorothy Davis found herself surrounded by a great team of lung cancer specialists at CentraState, including (from left) Jean-Phillipe Bocage, MD; Sharon Lorfing, RN, cancer navigator; and Jeffrey Silberberg, MD.

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